Do We Need New Guidelines for "Levels of Obesity" and Weight Gain during Pregnancy?

In recent years, obesity experts, in conjunction with Obstetrics and Gynecology experts have revised weight gain recommendations during pregnancy. The revisions came in light of obesity trends as well as the impact of a mother’s excess weight on the growing fetus, delivery outcomes, and the health destiny of a child.
It’s well known that a healthy pregnancy does require weight gain.
But if the woman is already carrying excess weight, especially a large amount of extra weight and gaining even the normally recommended amount of weight, it may create health hazards for both mom and the growing baby.

So the weight-gain guidelines
were revised several years ago to help offer weight gain ranges for newly pregnant women, based on their BMI and weight, at the time of conception.
These guidelines however, used only one classification for obesity, though a woman could be suffering from varying levels of obesity.

If the woman is underweight at the time of pregnancy, she should gain between 28 and 40 lbs.

If the woman is average weight at the time of pregnancy, she should gain between 25 and 35 lbs.

If the woman is overweight at the time of pregnancy, she should gain between 15 and 25 lbs.

If the woman is suffering from obesity at the time of pregnancy, she should gain between 11 and 20 lbs.

It is certainly conceivable that if a woman is suffering from extreme levels of obesity, it may not be beneficial for any weight gain to occur, or for very minimal weight gain to be the goal.

Classifications of Obesity

BMI measurements are used to more specifically classify those individuals with obesity.
Class I obesity covers a person whose BMI range is 30.0 to 34.9.
Class II obesity covers a BMI between 35.0 and 39.9, or less than 40.
Class III obesity is used to describe anyone who has a BMI of 40 or greater.

New Research

Recently, researchers decided to evaluate whether more specific guidelines for weight gain were appropriate, based on the degree of obesity at the start of pregnancy.
The goal was to see if certain weight gains adversely impact the health of a woman’s baby if she falls into one of the three classes of obesity.
The results, published in the March issue of Obesitys the first look at reference values for pregnancy weight gain, based on the differentclasses of obesity.Researchers looked at over 4,000 women who had pre-pregnancy BMIs greater than or equal to 25.These women all had uncomplicated pregnancies and deliveries.The researchers then extrapolated eleven "weight-gain measurements" for each of four weight categories - overweight, class I obesity, class II obesity, class III obesity.They did note a commonality overall, these women gained little if any weight in the first half of pregnancy.In the second half of pregnancy, slow weight gain_ seemed to be the most common finding that supported a healthy delivery, with a tapering of weight gain, the higher levels of obesity for the individual.

Research Outcomes

The hope is to expand the findings of this research model so that updated guidelines and recommendations can be made to address varying levels of pre-pregnancy obesity and weight gain, to ensure that both mother and baby are safe. Battling obesity during pregnancy can mean an increased risk of gestational diabetes, hypertension, preeclampsia, C-section delivery, and post-partum weight retention.
Babies born to obese mothers, face higher rates of premature birth, stillbirth, congenital anomalies, macrosomia, and childhood obesity.
The risk of these complications demands that weight gain be monitored more closely during pregnancy.
Hopefully the new data will further the research efforts to establish guidelines for women who enter pregnancy with serious weight issues.

What Can You Do Now?

If you are planning to get pregnant and have a weight issue, now is the time to talk with a health professional so you can begin an exercise and weight loss program before you start your pregnancy.
Many of the diet and exercise recommendations can be followed during your pregnancy, while you are under the care of a physician.
Your motivation can be having a healthy baby, limiting your own risk during the pregnancy and delivery, having less weight to lose in the postpartum period, and achieving better overall health.
A lifestyle change may also help you to engage your own family in better diet and fitness choices.

Known as The HealthGal, expert contributor Amy Hendel is a popular medical and lifestyle reporter, nutrition and fitness expert, columnist, and brand ambassador, as well as a health coach. Trained as a physician assistant, she maintains a health coach private practice in New York and Los Angeles. Author of The Four Habits of Healthy Families, you can find her on Twitter @HealthGal1103 and on Facebook at TheHealthGal. Her personal mantra is “Fix it first with food, fitness, and lifestyle.”